Take the Diabetes Health Pump Survey
See What's Inside
Read this FREE issue now
For healthcare professionals only
  • 12 Tips for Traveling With Diabetes
See the entire table of contents here!

You can view the current or previous issues of Diabetes Health online, in their entirety, anytime you want.
Click Here To View

See if you qualify for our free healthcare professional magazines. Click here to start your application for Pre-Diabetes Health, Diabetes Health Pharmacist and Diabetes Health Professional.

Learn More About the Professional Subscription

Free Diabetes Health e-Newsletter
Latest
Popular
Top Rated
Diabetes Health Reference Charts
Hypoglycemia Unawareness Archives
Print | Email | Share | Comments (0)

Ethnic Disparities Found in A1c Test


May 18, 2010

If the higher A1c levels found in black children are a factor of ethnicity, not actual elevated levels of blood glucose, they could have a potentially dangerous effect when treating diabetes based upon A1c.

A new study released by the Children's Hospital of New Orleans has found that black children with type 1 diabetes scored higher on A1c tests than white children who had similar blood glucose levels. Such ethnic disparity has already been shown in previous studies with adults.

The six-year study was led by Dr. Stuart A. Chalew, a professor of pediatrics at Louisiana State University Health Sciences Center. It tracked 276 children who averaged 12.5 years of age and had had type 1 diabetes for an average of about 5 years. The researchers looked at results of the A1c screening test, which is an indicator of blood sugar levels over the previous two to three months.

In the normal 120-day life span of the red blood cell, glucose molecules react with hemoglobin, forming glycated hemoglobin. Individuals with poorly controlled diabetes accumulate much more glycated hemoglobin than healthy people, which is reflected by higher A1c scores. Measuring glycated hemoglobin with the A1c test on a regular basis assesses the effectiveness of therapy by monitoring long-term serum glucose regulation. The study also tracked blood sugar levels from glucose tests that the participants gave themselves for at least a month.

The result of the study is that black children had statistically significantly higher A1c scores (9.1% ± 0.1) than white children (8.3% ± 0.1), independent of covariates. Results were controlled for age, diabetes duration, and mean blood glucose levels. 

The 2010 American Diabetes Association Standards of Medical Care in Diabetes has set an A1c higher than 6.5% as a criterion for the diagnosis of diabetes. Higher A1c's, which correspond with poorer glucose control, are handled with treatment options to bring a patient within the A1c guidelines, including treatment with insulin as well as lifestyle changes. The intensity of treatment is determined by how far off the guidelines the patient is.

If the higher A1c levels found in black children are a factor of ethnicity, not actual elevated levels of blood glucose, they could have a potentially dangerous effect when treating diabetes based upon A1c.

If these tests come back too high simply due to ethnic disparity, the intensive glycemic control required to reach an ostensibly healthy level could "unintentionally provoke increased episodes of life-threatening hypoglycemia [low blood sugar] in African-American patients," Dr. Chalew said. Thus, practitioners need to consider each individual patient's health, biological background, risk of hypoglycemia, and specific health risks when setting a target A1c level and determining treatment.

* * *

Sources:

HealthDay article

Study abstract

A1c information


Categories: A1c Test, Adolescent Boys, Adolescent Girls, Blood Glucose, Blood Sugar, Diabetes, Diabetes, Health Care, Hypoglycemia Unawareness, Insulin, Kids & Teens, Low Blood Sugar, Type 1 Issues



You May Also Be Interested In...


Comments


Add your comments about this article below. You can add comments as a registered user or anonymously. If you choose to post anonymously your comments will be sent to our moderator for approval before they appear on this page. If you choose to post as a registered user your comments will appear instantly.

When voicing your views via the comment feature, please respect the Diabetes Health community by refraining from comments that could be considered offensive to other people. Diabetes Health reserves the right to remove comments when necessary to maintain the cordial voice of the diabetes community.

For your privacy and protection, we ask that you do not include personal details such as address or telephone number in any comments posted.

Don't have your Diabetes Health Username? Register now and add your comments to all our content.

Have Your Say...


Username: Password:
Comment:
©1991-2014 Diabetes Health | Home | Privacy | Press | Advertising | Help | Contact Us | Donate | Sitemap

Diabetes Health Medical Disclaimer

The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained on or available through this website is for general information purposes only. Opinions expressed here are the opinions of writers, contributors, and commentators, and are not necessarily those of Diabetes Health. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this website.